Yield of repeat fine-needle aspiration biopsy and rate of malignancy in patients with atypia or follicular lesion of undetermined significance: The impact of the Bethesda System for Reporting Thyroid Cytopathology

Chen, Joy C.; Pace, S; Chen, Boris A.; Khiyami, Amer; McHenry, Christopher R.

doi:10.1016/j.surg.2012.08.052

Cited by 88 publications

(94 citation statements)

References 21 publications

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“…In the study repeat FNA was performed 26 times, which comprises 46.4% [15]. These data are considerably divergent, but that probably depends on different socio-economic conditions.…”

Section: Discussionmentioning

confidence: 99%

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Kliniczne znaczenie rozpoznania zmiany pęcherzykowej bliżej nieokreślonej (grupa III wg Systemu Bethesda) w biopsji aspiracyjnej cienkoigłowej (BAC)

Stanek-Widera

Biskup-Frużyńska

Zembala‐Nożyńska

et al. 2016

Endokrynologia Polska

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Introduction: Follicular Lesion of Undetermined Significance (FLUS) belongs to the most controversial category of the Bethesda System. The aim of the study was to specify the risk of malignancy in patients with FLUS diagnosis in the material from the Institute of Oncology in Gliwice. This is the first Polish study specifying the risk of malignant neoplasm presence when Fine-Needle Aspiration Biopsy (FNAB) results in a report of diagnostic category III (DC III). Material and methods: Three hundred and ninety-five primary DC III diagnoses from FNABs of the thyroid gland performed from 2010 to 2015 were analysed. Correspondence of DC III with diagnoses from repeated FNABs and histopathology reports was evaluated. Results: From 395 DC III patients, 27 were treated surgically for clinical indications, receiving six diagnoses of cancer. Repeat FNAB was performed in 180 cases, and primary diagnosis was confirmed in 41 cases. In the second FNAB there was one diagnosis of "Papillary Thyroid Carcinoma" and one "Suspicious for Papillary Thyroid Carcinoma". From eight patients treated surgically in these series prior cytological cancer diagnosis was confirmed in two cases. Forty-six patients were subjected to third and subsequent FNABs; in one case the diagnosis was "Suspicious for Malignancy". In the analysed material the risk of cancer in patients with FLUS is 2.78%. Taking into account all 56 subsequent FNABs in which the primary diagnosis was confirmed, the risk decreases to 2.43%. Conclusions:The diagnosis of FLUS in the absence of clinical indications is not a basis for surgical treatment.

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“…In the study repeat FNA was performed 26 times, which comprises 46.4% [15]. These data are considerably divergent, but that probably depends on different socio-economic conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Joy et al compared two groups of patients: one categorised before the creation of Bethesda System (BS) and another, similar in number, in which the diagnoses were compatible with the recommendations of the BS. The researchers noticed that the implementation of DC III caused a reduction in the number of thyroidectomies [15].…”

Section: Discussionmentioning

confidence: 99%

Kliniczne znaczenie rozpoznania zmiany pęcherzykowej bliżej nieokreślonej (grupa III wg Systemu Bethesda) w biopsji aspiracyjnej cienkoigłowej (BAC)

Stanek-Widera

Biskup-Frużyńska

Zembala‐Nożyńska

et al. 2016

Endokrynologia Polska

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“…7 The recommended management is clinical correlation and a repeat FNAB in 3 to 6 months. 10 It has been recommended that if there is an indication for surgical intervention, it is not necessary to repeat the FNAB. 4 Although it has been suggested that the usage of AUS/FLUS should not exceed 7% of thyroid FNABs, 3,7,9,10 there is variation of this percentage from 3 to 29% across laboratories and from 2.5 to 28.6% among cytopathologists.…”

Section: Introductionmentioning

confidence: 99%

“…10 It has been recommended that if there is an indication for surgical intervention, it is not necessary to repeat the FNAB. 4 Although it has been suggested that the usage of AUS/FLUS should not exceed 7% of thyroid FNABs, 3,7,9,10 there is variation of this percentage from 3 to 29% across laboratories and from 2.5 to 28.6% among cytopathologists. 5 Ultrasound findings can facilitate reaching a diagnosis of nodules with AUS/FLUS, 11 although they may not differentiate benign from malignant nodules.…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy

Alqahtani¹,

Al-Sobhi²,

Alsalloum³

et al. 2017

World Journal of Endocrine Surgery

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Aim: To correlate selected clinical and ultrasonographic (US) characteristics with the final histopathological diagnosis in patients with atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS), and whether this information can be used in planning the surgical approach. Materials and methods:It is a retrospective study including the operated cases of AUS/FLUS from 2011 to 2014 treated at one center.Results: This cohort included 87 women and 28 men. To test for independence between categorical variables, the chi-square test was used. There was no significant correlation between age or US variables and final pathological diagnosis. However, final diagnosis of malignancy was higher in men compared with women (64.3 and 41.4% respectively; p = 0.035). Furthermore, a significant association between the diagnosis of repeated fine needle aspiration biopsy (FNAB) and the final pathological diagnosis was noted (benign vs malignant, p = 0.005). Conclusion:The FNAB has a significant role in the assessment of thyroid nodules. Our results showed no correlation between age, US variables, and the risk of malignancy. Male gender is associated with higher risk of malignancy.Clinical significance: Determining the risk of malignancy and prediction of surgical outcome may help triaging cases for repeat FNA or proceeding to surgery.

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“…7 But in Texas and Ohio, they reported a malignancy rate of 13 and 19% respectively. 9,10 A study in South Korea reported a malignancy rate of 47%, while an academic institution in the US reported a malignancy rate of 48%. 12,15 These reported rates are higher than the implied risk of malignancy (5-15%) adopted by the Bethesda System.…”

Section: Discussionmentioning

confidence: 99%

Management and Malignancy Rate of Thyroid Nodules with a Cytologic Diagnosis of Atypia or Follicular Lesion of Undetermined Significance

Carlos

Mirasol

Aquino

et al. 2014

JAFES

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Objective. This study describes the clinical data of adult patients who underwent Fine Needle Aspiration Biopsy (FNAB) of thyroid nodule(s) with a cytologic diagnosis of Atypia or Follicular Lesion of Undetermined Significance (AUS or FLUS) at St. Luke's Medical Center from January 2012 to October 2013.Methodology. Adult patients who underwent FNAB of the thyroid nodule with a cytologic diagnosis of AUS or FLUS were studied retrospectively using the ultrasound result, initial consultation form and operative techniques of these patients. The cytologic and histopathologic diagnoses were retrieved through the electronic Healthcare-Results Management System.Results and Conclusion. A third (34%) of the patients with a cytologic diagnosis of AUS or FLUS (8.9%) underwent surgery. Of the 68 patients who underwent surgery, 44 were benign and 24 were malignant with a malignancy rate of 35.3%. Preoperatively, there were no ultrasound characteristics or microscopic descriptions significantly associated with malignancy. The recommendation of the Bethesda System to do a repeat FNAB in these thyroid nodules should, therefore, be reconsidered.

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Yield of repeat fine-needle aspiration biopsy and rate of malignancy in patients with atypia or follicular lesion of undetermined significance: The impact of the Bethesda System for Reporting Thyroid Cytopathology

Cited by 88 publications

References 21 publications

Kliniczne znaczenie rozpoznania zmiany pęcherzykowej bliżej nieokreślonej (grupa III wg Systemu Bethesda) w biopsji aspiracyjnej cienkoigłowej (BAC)

Kliniczne znaczenie rozpoznania zmiany pęcherzykowej bliżej nieokreślonej (grupa III wg Systemu Bethesda) w biopsji aspiracyjnej cienkoigłowej (BAC)

Surgical Outcome of Thyroid Nodules with Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Fine Needle Aspiration Biopsy

Management and Malignancy Rate of Thyroid Nodules with a Cytologic Diagnosis of Atypia or Follicular Lesion of Undetermined Significance

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